Let's change the question: what are your dreams?

April 28, 2008
Fiorella Horna-Guerra

Fiorella Horna-Guerra

It’s an age-old curiosity: one person born into poverty falls prey to his circumstances; another becomes a success and inspiration. What causes a life to follow one path or another?

Fiorella Horna-Guerra would answer, Work, hope and a miracle or two.

Currently serving as consultant to the North Carolina Farmworker Health Program in the N.C. Department of Health and Human Services’ Office of Rural Health and Community Care, Horna-Guerra knows first-hand about her clients’ circumstances. When she was five years old, her family moved from Lima, Peru, to New York City in search of a new beginning. Two months later, her father returned to Peru, with no explanation, leaving behind his wife and young daughter in a country where they knew little about the language and customs.

Horna-Guerra’s mother, whose most marketable job skill was sewing, grew up in an era when women in Peru were not encouraged to go to school. Still, says Horna-Guerra, her mother’s faith, love for learning, work ethic, independence and resilience allowed them to live a productive and secure life.

Horna-Guerra has spent her adult life giving back.

A 2006 graduate of Carolina’s Emerging Leaders in Public Health Program, a program of the North Carolina Institute for Public Health, Horna-Guerra says that early in her career as community outreach coordinator in a Medicaid managed care plan for Metropolitan Hospital in New York and through her work at the Manhattan Borough President’s office, she often found herself influencing legislation and advocating for expanded funding for health-based programs.

In 1993, when she moved to Cary, N.C., she was hired as program manager for the Community-based Public Health Initiative at the Lee County Health Department in Sanford, N.C.

“You’re not from around here, are you?” is the question she remembers hearing most often. Her colleagues wondered if a feisty, 5-foot-1-inch Latina could work with the primarily African American population they served. People she tried to help thought she talked too fast and had “big-city” ways.

Horna-Guerra says she had to learn to be an advocate and educator as well as a mover and shaker. “I served as a resource to people as they empowered themselves to look for the services they needed. And I had to talk a lot slower,” she says.

Dr. John Hatch, Kenan Distinguished Professor Emeritus of health behavior and health education, was one of Horna-Guerra’s mentors. “Don’t just ask people what they need,” she remembers Hatch telling her. “Let’s change the question. Ask them what their dreams are.”

Horna-Guerra says she got surprising responses to that question. Rather than focus on what people lacked, she says she found ways to identify their strengths, inborn talents and assets to help them attain their goals and access services. She’s continuing to do that today.

“North Carolina is different from New York in many ways — not the least of which is the number of uninsured, working poor. People here may be overlooked for various reasons and thus experience limited access to getting their needs met.

“It’s one of the things that I’m working on changing,” she says with a grin.

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Carolina Public Health is a publication of the University of North Carolina at Chapel Hill School of Public Health. To subscribe to Carolina Public Health or to view the entire Spring 2008 issue in PDF, visit www.sph.unc.edu/cph.